Clinical Study On Efficacy And Safety Of Intrathecal Analgesia In Treatment Of Refractory Cancer Pain

Objective: To evaluate the efficacy and safety of intrathecal analgesia in the treatment of refractory cancer pain.Methods: A total of 13 patients were retrospectively reviewed,who diagnosed as refractory cancer pain and treated by intrathecal analgesia in the department of pain,the First Affiliated Hospital of Chongqing Medical University,of from january 2013 to June 2018,including 9 males and 4females.Record the visual analog scales(VAS)scores of 1 day before operation and 1 day,1 week,2 weeks,1 month,2 months and 3 months after operation.Record the GAD-7 anxiety scores,PHQ-9 depression scores and SF-36 quality of life questionnaire scores of 1 day,1 week,2 weeks,1month,2 months and 3 months after the operation,the average daily dose of morphine before and after operation.Calculate the pain relief rates of 1day,1 week,2 weeks,1 month,2 months and 3 months after the operation.Meanwhile,record the adverse reactions such as respiratory depression,constipation,urinary retention,nausea and vomiting,itching,dizziness,drug addictions,infections,low intracranial pressure,cerebrospinal fluid leakage and other adverse reactions,and catheter blockage,equipmentfailure and so on.Results: Three patients died 1 month after the operation because of the progression of the disease,and two patients died 2 months after the operation.Compared with the one day before operation,the VAS scores of intrathecal analgesia patients were significantly lower at 1 day,1 week,2weeks,1 month,2 months and 3 months after the operation,the pain relief rates at each time point was more than 50%,the dosage of morphine decreased significantly.The anxiety and depression scores of patients at 1week,2 weeks,1 month,2 months and 3 months after operation were lower than those before operation.Only the BP scores of SF-36 quality of life score was higher than that before operation,while the others remained unchanged.Three patients had nausea and vomiting on the first day after operation,and one patient had constipation on the first day after operation,all of these was relieved after symptomatic treatments.During the whole process,there were no low intracranial pressure,cerebrospinal fluid leakage,infection,equipment leakage,catheter blockage,equipment failure.Conclusion: Intrathecal analgesia is effective and safe in the treatment of refractory cancer pain.